Carl J. Shapiro Department of Orthopaedics, Division of Foot and Ankle Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
Department of Radiology, Division of Musculoskeletal Imaging and Intervention, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Foot Ankle Spec. 2022 Jun;15(3):258-265. doi: 10.1177/1938640020950897. Epub 2020 Aug 27.
Peroneal tendon pathology is common. Several factors have been implicated, including low-lying muscles and accessory tendons. Studies have reported on the presence and length measurements of these structures. This study evaluates volume measurements within the sheath using magnetic resonance images for patients with operatively treated peroneal tendon pathology and control patients without peroneal disease.
Fifty-one patients with peroneal tendon pathology and 15 controls were included. The volumes of the peroneal sheath, peroneal tendons, peroneal muscle, and accessory peroneus tendons were measured. The distal extent of the peroneus brevis (PB) muscle was measured. Volume and length measurements were then compared.
The mean PB muscle length from the tip of the fibula was 5.55 ± 2.5 mm (peroneal group) and 11.79 ± 4.07 mm (control) ( = .017). The mean peroneal sheath volume was 7.06 versus 5.12 mL, respectively ( = .001). The major contributors to this increased volume was the tenosynovitis (3.58 vs 2.56 mL, respectively; = .019), the peroneal tendons (2.17 vs 1.7 mL, = .004), and the accessory peroneus tendon + PB muscle (1.31 vs 0.86 mL, = .023).
The current study supports that the PB muscle belly is more distal in patients with peroneal tendon pathology. The study also demonstrates increased total volume within the peroneal sheath among the same patients. We propose that increased volume within the sheath, regardless of what structure is enlarged, is associated with peroneal tendon pathology. Further studies are needed to determine if debridement and decompression of the sheath will result in improved functional outcomes for these patients.
Level III: Case control imaging study.
腓肠肌腱病较为常见。多种因素与之相关，包括低位的肌肉和副肌腱。已有研究报道了这些结构的存在和长度测量。本研究通过磁共振成像评估了手术治疗的腓肠肌腱病患者和无腓肠肌腱病的对照患者的鞘内容积测量值。
纳入 51 例腓肠肌腱病患者和 15 例对照者。测量腓肠肌腱鞘、腓肠肌腱、腓肠肌和副腓骨长肌的体积。测量腓骨短肌（PB）肌的远端范围。然后比较容积和长度测量值。
从腓骨尖端测量，PB 肌的平均长度在腓肠肌腱病组为 5.55 ± 2.5mm，在对照组为 11.79 ± 4.07mm（ =.017）。腓肠肌腱鞘的平均体积分别为 7.06 和 5.12mL（ =.001）。体积增加的主要原因是腱鞘炎（3.58 比 2.56mL， =.019）、腓肠肌腱（2.17 比 1.7mL， =.004）和副腓骨长肌+PB 肌（1.31 比 0.86mL， =.023）。
本研究支持在患有腓肠肌腱病的患者中，PB 肌腹更靠远端。该研究还表明，同一患者的腓肠肌腱鞘内总容积增加。我们提出，鞘内容积增加，无论哪个结构增大，都与腓肠肌腱病有关。需要进一步研究以确定鞘内清创和减压是否会改善这些患者的功能预后。
III 级：病例对照影像学研究。
